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DR. KENNETH M SCHWARTZ M.D.
NPI 1164606372
Surgery in Middletown, CT

Active since December 24, 2007PECOS EnrolledAccepts Medicare Assignment
84.47/100
CMS Quality Rating
410 SAYBROOK RD # C, MIDDLETOWN, CT 06457(860) 358-2970(860) 347-1630 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kenneth M Schwartz M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH M SCHWARTZ M.D. (NPI 1164606372) is an individual surgery provider in Middletown, Connecticut, licensed in Connecticut (051745) and active in the NPI registry since December 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1164606372
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. KENNETH M SCHWARTZCredential: M.D.
Location Address410 SAYBROOK RD # CMiddletown, CT 06457-4777
Mailing Address410 Saybrook Rd # CMiddletown, CT 06457-4777 · (860) 358-2970 · Fax (860) 347-1630
Phone(860) 358-2970
Fax(860) 347-1630
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateDecember 24, 2007
Last NPPES UpdateNovember 12, 2025
NPPES CertifiedNovember 12, 2025
✔ NPI 1164606372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in CT · 051745
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
410 SAYBROOK RD # C, Middletown, CT 06457
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth M Schwartz M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456593359
PECOS Enrollment IDI20130806000002
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kenneth Schwartz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mhs Primary Care
0.3 mi
Family Medicine
520 SAYBROOK RD, SUITE N100
Middletown, CT 06457
  • Reassigned Medicare billing, Connecticut enrollment
  • 147 clinicians in this Medicare group
NPI 1639399959 (860) 344-1801

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
22 services18 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
21 services11 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
19 services19 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
18 services17 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.28
Promoting Interoperability100
Improvement Activities40
Cost59.59

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Schwartz's NPI number?

The NPI number for Kenneth Schwartz is 1164606372. It was assigned to this individual provider in the NPPES registry on December 24, 2007.

Where is Kenneth Schwartz located?

Kenneth Schwartz practices at 410 Saybrook Rd # C, Middletown, CT 06457. The listed phone number is (860) 358-2970.

What is Kenneth Schwartz's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Kenneth Schwartz enrolled in Medicare?

Yes. Kenneth Schwartz is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kenneth Schwartz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Schwartz reassigns Medicare benefits to Mhs Primary Care (Middletown, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Schwartz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenneth Schwartz accept?

Health plans from Anthem Blue Cross and Blue Shield list Kenneth Schwartz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenneth Schwartz was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.